Summary

This US study asked children who had socially transitioned (living fully as the other gender, with family support) to rate their own depression, anxiety and self-worth. It compared them with matched children and with their brothers and sisters. The trans children reported normal levels of depression and self-worth and slightly more anxiety; parents reported similar results. The authors contrasted this with earlier clinic studies of gender-nonconforming children who had not transitioned, which found much more distress. But families were found through support networks, were mostly well-off and supportive, and children did not need a diagnosis of gender dysphoria. With nothing measured before transition, the study cannot show social transition caused the good mental health. Later careful reviews rate this kind of evidence as low quality.

Key findings

• 63 名進行過社會性過渡的 9–14 歲跨性別兒童、63 名配對兒童和 38 名兄弟姊妹，使用簡短問卷自評了憂鬱和焦慮。
• 各組之間的憂鬱沒有差異，跨性別兒童的分數與美國平均值一致。
• 跨性別兒童回報的焦慮稍多，不過差異可能只是偶然；家長回報的焦慮則明顯多於其他兒童，且高於美國平均值。
• 116 名 6–14 歲跨性別兒童的自我價值，與其他兒童或他們的兄弟姊妹沒有差異。
• 跨性別兒童的家長回報的焦慮比兒童自己回報的稍多，作者認為這顯示家長並沒有隱瞞問題。
• 這些家庭是透過支持團體、夏令營和跨性別兒童家庭的網路論壇找到的，高收入者的比例高得多。
• 作者表示，他們無法結論社會性過渡造成了這些結果，而且問題可能隨著孩子長大才出現。

Abstract

OBJECTIVE: Social transitions are increasingly common for transgender children. A social transition involves a child presenting to other people as a member of the "opposite" gender in all contexts (e.g., wearing clothes and using pronouns of that gender). Little is known about the well-being of socially transitioned transgender children. This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children. METHOD: As part of a longitudinal study (TransYouth Project), children (9-14 years old) and their parents completed measurements of depression and anxiety (n = 63 transgender children, n = 63 controls, n = 38 siblings). Children (6-14 years old; n = 116 transgender children, n = 122 controls, n = 72 siblings) also reported on their self-worth. Mental health and self-worth were compared across groups. RESULTS: Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728). CONCLUSION: These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems.

Conclusion

These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems. In the discussion the authors add that they cannot conclude social transition caused the outcomes, that the children may face greater issues as they mature, and that the high-income skew of the sample limits generalisation; they suggest the results provide converging evidence that early family support is associated with positive mental health in transgender children.